Evaluation the combination of amoxyclav with amikacin and ceftriaxone against Escherichia coli sepsis

Background: Escherichia coli (E. coli) is one of the most common causes of bloodstream infections, it is capable of gaining access to and surviving in the bloodstream are known as extra-intestinal. This research was performed to study the effect of some antibiotics on the growth of bacteria by combination with amoxiclav. Methods: The bacteria (E. coli) was isolated from bloodstream and cultured in three media (blood agar, MacConkey agar, and eosin methylene blue agar), then they were incubated for 24 hours at a temperature of 37 oC to grow. Well diffusion method is used for antibiotic sensitivity evaluation, after overnight incubation, the diameter of the inhibited growth is measured. Fifty µL of the antibiotics (ceftriaxone, amikacin, and amoxyclav) was added separately in one petri dish, and they were added in another petri dish combined with the amoxyclav, to evaluate the effect of antibiotics on the growth of bacteria before and after the addition of amoxyclav. Results: The study showed that males are more infected with 65% of the samples, and it showed that females are less infected, at 35% of the samples without significant differences (p= 0.18). The mean of inhibition zone of amikacin alone was 32.95± 5.95 that increased significantly when combined with amoxyclav 37.40± 5.36 (p= 0.018). Combination of ceftriaxone with amoxyclav showed increased in inhibition zone 43.10± 9.48 than ceftriaxone alone 39.05± 11.55 without significant differences was observed (p= 0.23). Positive strong correlation was observed between amoxyclav and amikacin (r= 0.74, p< 0.001). Conclusions: Combination of amikacin with amoxyclav has synergism effect against E. coli clinically isolated from patients with bloodstreams (p = 0.018). Addition of ceftriaxone to amoxyclav showed synergism effect but it still insignificant (p = 0.23).